Permit t! .1 / CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00604
'71, DEVELOPMENT SERVICES DATE ISSUED: 8/18/2005
r `"' 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S111 CC -04300
SITE ADDRESS: 15925 SW CENTURY OAK CIR ZONING: R -7
SUBDIVISION: SUMMERFIELD LOT : 066 JURISDICTION: TIG
Project Description: AC circuit and outlet.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL /PANEL:
MANF HMI SVC/ FDR: 601 +amps -1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 1 IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL: •
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
HANSEN, ELSA M TRUSTEE . SHARPE ELECTRIC INC
15925 SW CENTURY OAK CIRCLE 22605 SW RIGGS
TIGARD, OR 97224 BEAVERTON, OR 97007
Phone: 503 - 639 -2953 Phone: 642 -7937
FEES Reg #: LIC 81518
Description Date Amount SUP 3344S
ELE 34 -217C
[ELPRMT] ELC Permit 8/18/2005 $53.50
[TAX] 8% State Surcharge 8/18/2005 $4.28 REQUIRED ITEMS AND REPORTS
Total $57.78
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specia ty Codes and all other applicable laws.
All work will be done in accordance with approved plans. This permit will expire if work is not started within 80 days of issuance, or if work is
suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the • r ;.on Utility Notification Center. Those
rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these r • - 4 direct questio . to OUN C at
503 - 246 -6699 or 1-:..:•1-332-2 4.
Issued By: ..416 _/ il Permittee Signature /
OWNER INSTALLATION ONLY '
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 503 -639 -4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
•
•
` 4. FOR OFFICE USE ONLY '
Electrical Permit Application Receive d a Elec ,yr�
Date/By � � D�� al J� Permit N�'�(,ei
City of Tigard 0 j . 0 Planning Approvaft Sign
Y ���� g Date /By: Petmit No.:
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 MC j . 8 � t t lr.l Date/By: Permit No.:
Phone: 503- 639 -4171 Fax: 503 -598 -1960 both
CITY I1 Post- Review Land Use
Internet: www.ci.tigard.or.us _ OFT
r
g p o Q,,„ 61 I Date/By: Case No.:
Contact s.: See Page 2 for
24 -hour Inspection Request: 503-63 4 `: y �� iviy °' ® Name /Method: Supplemental Information.
.1`04 ' >;: QTY POOP°WORK ; Ati l i M . rNP.L/ANA'WltW . Please. 11MeattWit a I ` R' ,,
❑ New construction D Demolition ❑ Service over 225 amps- ❑ Health -care facility
commercial ❑ Hazardous location
❑ Addition/alteration/replacement Other: ❑ Service over 320 amps- rating of ❑ Building over 10,000 square feet,
_4` '; `4 p =n µ'.' ; ? 1 & 2 family dwellings four or more residential units in
�T�' #�� �. , ; �; �' CAT.EGO,RY�®F�CONSTRUCTION�`��. _ , • `y' � a s , y g
�` 0 System over 600 volts nominal one structure
& 2- Family dwelling El Commercial /Industrial
❑ Building over three stories ❑ Feeders, 400 amps or more
•, Accessory Building ❑ Multi - Family ❑ Occupant load over 99 persons ❑ Manufactured structures or RV park
❑ Master Builder ❑ Other: 11 Egress/lighting plan ❑ Other:
S sets of plans with any of the above.
, "J,OB SITE'INFORMATIbN,-andI OCATION r = p y
..��
"" The above are not applicable to temporary construction service.
Job site address: iS� S Su - 4 1 .k 0 1 r�c �-es ` ;°;'; ; l., W : eF�EE SCHEDIJIJE ;, .i `. i ; � �'
Suite #: Bldg./Apt. #: Number of inspections per permit allowed
Project Name: 1-4-a 4 A seri /4 Am Se A Description Qty Fee (ea.) Total
Cross street/Directions to job site: New residential-single ude attached ed ga per i
.1 dwelling unit. Includes attached garage.
Service included:
1000 sq. ft. or less 145.15 4
Each additional 500 sq. ft. or portion thereof 33.40 1
Limited energy, residential 75.00 2
Subdivision: Lot #: Limited energy, non residential 75.00 2
Tax map /parcel #: home or modular dwelt
Each manufactured hom dwelling
M y e p. V r g T W0 _ , service feeder 90.90 2
p.,. +.t:` ;DESCRIPTION,OF :, , . Services an or d/or feeders - installation,
alteration or relocation:
200 amps or less 80.30 2
201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
g la (PROPERTY JWNERw",�.,.^ ,. ` ` TENANT , ? ;, ,r7 I 601 amps to 1000 amps 240.60 2
A
' "' �� ` Over 1000 amps or volts 454.65 2
Name: / Reconnect only 66.85 2
Address: CPi ti Temporary feeders- installation,
alteration, or relocation or :
City /State /Zip: /� 200 amps or less 66.85 1
Phone :5'6,3 �i3� I Fax: 201 amps to 400 amps 100.30 2
401 to 600 amps 133.75 2
❑APi'LIC'ANT ,. ,; . ,q_ . •',CONTVAC IiPE $SQ1Vs ,,: ,2. Branch circuits - new, alteration, or
Name: extension per panel:
A. Fee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit 6.65 2
City /State /Zip: B. Fee for branch circuits without purchase of t
•
service or feeder fee, first branch circuit 1 46.85 2
Phone: I Fax: Each additional branch circuit ( • 6.65 2
E- mail: Misc.(Service or feeder not included):
x „ CON TRACT_ ®12',,,,_ ` , , Each pump or irrigation circle 53.40 2
x =' `'� �` Each sign or outline lighting 53.40 2
Job No: Signal circuit(s) or a limited energy panel,
r �i ,, alteration, or extension Page 2 2
n Business Name: S� , � f - 11°_ (, i t VIC Description:
S � Address: 0 / 5 t( ,) I "'- s
, City /State /Zip: A & IA) a � 70� Each additional inspection over the allowable in any of the above: Q -� Per inspection per r hour our ( (min. 1 hour) 62.50 .50
41 Phone: £2 - 713 Fax: 6 (4 a1,- ' q 7 9 / Investigation fee: .
CCB Lic. #: Li # -/— � 7 C. Other:
�� 1 - ;,,:� Electrl ac I Parrott F ee s
i �' " ..r:''s` w .�4 � ;� ?. � ' S5_..: ;� 1 ., .�&�fR.3+.. G `' :
Supervising electrici / +� A '? — '"
Subtotal $ , _ct?
si: ature .e.,uiredi ` `,/ Plan Review (25% of Permit Fee) $
Print Namel M to N Lic. #: 3 3 J(4 State Surcharge (8% of Permit Fee) $ 4. .11(
-/ TOTAL ��� 0 7 TOTAL PERMIT FEE $ 5'7 * 7 '
Author' ed r ' Notice: This permit application expires if a permit is not obtained within
Si, • e: a jkk. a j .4 .a /. j • Date: — 1 —� 180 days after it has been accepted as complete.
*Fee methodology set.by Tri- County Building Industry Service Board.
1 �' e ��� It J (Pleas �� print name)
is \Dsts\Permit Forms \ElcPermitApp.doc 01/03
4
Electrical Permit Application - City of Tigard
. Page 2\ Supplemental Information •
LIMIT b 1 ENERGY PERMIT FEES:
RESIDENTI •\ WORK ONLY:
Fee for all syste $75.00
Check Type of Work volved:
n Audio and Ste -o Systems
n Burglar Alarm
Garage Door Opener
n Heating, Ventilation and A Conditioning System
Vacuum Systems
n Other
COMMERCIAL WORK ONLY:
Fee for each system $75.00
(SEE OAR 918- 260 -260)
Check Type of Work Involved:
n Audio and Stereo Systems
n Boiler Controls
n Clock Systems
F - 7 Data Telecommunication Installation
n Fire Alarm Installation
n HVAC
n Instrumentation
n Intercom and Paging Systems
n Landscape Irrigation Control
n Medical
n Nurse Calls
l l Outdoor Landscape ' fighting*
n Protective Si l5 ing
n Other
Number of Systems
* No licenses are required. Licenses are required for all , " , •
otlier' installations
i:\Dsts\Permit Forms\ElcPermitAppPg2.doc 01/03
CITY OF TIGARD
BUILDING DIVISION • --- PERMIT #: ELC2005-00604
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: ail woos
Phone: (503) 639-4171 . :N11400,tit
Inspection Requests (24 Hrs.): (503) 639-4175 -.JAI .....
INSPECTION WORKSHEET FOR DATE: 2/2/2006 TIME: 7O2Atvi PAGE: 75
SITE ADDRESS: 1.926 SW CENTURY OAK UR CLASS OF WORK:
SUBDIVISION: SUMMERFIELD LOT #: 066 TYPE OF USE:
PROJECT NAME: HANSEN
DESCRIPTION: AC circuit and outlet.
OWNER: HANSEN, JEANNE PHONE #: 603-3204980 (cell)
CONTRACTOR: SHARPE:. ELECTRIC INC PHONE #: 642-7937
Inspection Request Scheduled For: Date: 2/212006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical find 026129 503 N
Corrections/Comments/Instructions:
.----
. _
x _
PASS • APPROVAL 7 CANCEL NO ACCESS
7 FAIL ,ra C2LL FOR INSPECTION 7 ADDITIONAL FEES ASSESSED
Inspector Date: Z . Z ' 0 6 Phone #: (503) 718-
Th,
CITY OF TIGARD
BUILDING DIVISION . - - - PERMIT #: Ft.C2005.00604
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/18/2006
Phone: (503) 639-4171 . 70/pirathi,*
Inspection Requests (24 Hrs.): (503) 639-4175 ,,,lik 11.
INSPECTION WORKSHEET FOR DATE: 1124/2006 TIME: 6:58MA PAGE: t34
SITE ADDRESS: 15925 SW CENTURY OAK CIE
CLASS OF WORK:
SUBDIVISION: SUMMERFIELD LOT #: 066
TYPE OF USE:
PROJECT NAME: flANSElki
DESCRIPTION; AC circuit and outlet.
OWNER: HANSEN, JEANNE PHONE #: 503-320.8980 (cell)
CONTRACTOR: SHARPE ELECTRIC INC PHONE #: 542
Inspection Request Scheduled For: Date: 1/2412006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 026396 503-603-2512 V
Corrections /Comments/ Instructions:
— M //Y / / A ,7_
_
0) ., p4„ /, ,
"`.
Z 6 6 if Pri;L /4-4(17 I INcoKer
iv I — G t I I-4- ,L eT — I P \ / • is
- T6 .- T - r - 1 - < - N(7( _ . Z-c:70 , / I ) Al E r Z___/ 0, P) 6 Ft- I
z 062 r b ` _____
i
ThasiectricaLinstallatiotulefectsnoted
on this report shall be corrected and
an inspection request made within 2n
calendar days per OAR 918-271-0030
fl PASS EP PARTIAL APPROVAL fl CANCEL I I NO ACCESS
k FAIL uALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
Inspector: IIIAMIIIIIIIrilkb. Date: Z.q:0
Phone #: (503) 718- 6- 1
-,-,
CITY OF TIGARD
, ,
BUILDING DIVISION PERMIT #: ELC200 -00604
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/18/2005
Phone: (503) 639 -4171 - kmlyu� ,,� 'I I
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 11/14/2005 TIME: 7:12AM PAGE: 127
SITE ADDRESS: 15925 SW CENTURY OAK CIR CLASS OF WORK:
SUBDIVISION: SUMMERFIELD LOT #: 066 TYPE OF USE:
PROJECT NAME: HANSEN
DESCRIPTION: AC circuit and outlet.
OWNER: HANSEN, ELSA M TRUSTEE, PHONE #: 503- 639 -2953
CONTRACTOR: SHARPE ELECTRIC INC L PHONE #: 642
Inspection Request Scheduled For: Date: 11/14/2005 Pour Time:
Code \# Inspection Description Confirm # Contact # Message
199 V Electrical final 021084 -01 503-649-1271 Y
Corrections /Comments /Instructions:
�Il S SP `57)3
ivo 01414 A( Pk y
The electrical installation defects noted
on - this report shall be corrected and
an inspection request made within 20
calendar days per OAR 918 -271 -0030
) V4 1 \O5 'h. Y`(\
I I PASS Ii PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
UN FAIL I I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: C�h� !—ti
Date: / Phone #: (503) 718 -